Abstract
Bacterial biofilm formation is one of the main reasons for a negative treatment outcome and a high recurrence rate for many chronic infections in humans. The optimal way to study both the biofilm forming bacteria and the host response simultaneously is by using discriminative, reliable, and reproducible animal models of the infections. In this review, the advantages of in vivo studies are compared to in vitro studies of biofilm formation in infectious diseases. The pig is the animal of choice when developing and applying large animal models of infectious diseases due to its similarity of anatomy, physiology, and immune system to humans. Furthermore, conventional pigs spontaneously develop many of the same chronic bacterial infections as seen in humans. Therefore, in this review porcine models of five different infectious diseases all associated with biofilm formation and chronicity in humans are described. The infectious diseases are: chronic wounds, endocarditis, pyelonephritis, hematogenous osteomyelitis, and implant-associated osteomyelitis (IAO).
Highlights
Chronic bacterial infections are a major healthcare problem and of increasing concern due to their high burden with respect to economic costs, increased bacterial antibiotic resistance, high morbidity, and mortality (Archer et al, 2011; Roberts et al, 2015)
As seen from the descriptions of infections in the present review (Figure 3) it is likely that all chronic porcine infections are the cause of biofilm formation as in humans (Donlan and Costerton, 2002; Costerton et al, 2003; Brady et al, 2008)
This assumption has been supported in porcine pneumonia due to Actinobacillus pleuropnumoniae (Tremblay et al, 2017)
Summary
Chronic bacterial infections are a major healthcare problem and of increasing concern due to their high burden with respect to economic costs, increased bacterial antibiotic resistance, high morbidity, and mortality (Archer et al, 2011; Roberts et al, 2015). Pigs have been used to model the following chronic bacterial diseases, all known to be associated with biofilm formation in humans; chronic wounds, endocarditis, pyelonephritis, hematogenous osteomyelitis, and implant-associated osteomyelitis (IAO). Strain S85 (Group L), resulted in endocarditis in the pigs and was used in his further studies (Table 3; Jones, 1969, 1981, 1982) He found that macroscopic lesions developed as early as 18 h after inoculation and that the lesions in general matched those seen in humans (Jones, 1969). A vesico-urethral reflux model was established in Sinclair mini-pigs for the study of chronic atrophic pyelonephritis (Table 4; Hodson et al, 1975) Both the inoculated and noninoculated group developed scarring composed of fibrosis and leukocyte infiltration.
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